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AnteayerInternacionales

Trust and confidence of clinical staff and patients is crucial for the successful introduction of artificial intelligence (AI) in mental healthcare

Por: Barrera · A.

Commentary on: Higgins O, Short BL, Chalup SK, et al. Artificial intelligence (AI) and machine learning (ML) based decision support systems in mental health: an integrative review. Int J Ment Health Nurs 2023 [Epub ahead of print 6 Feb 2023]. doi: 10.1111/inm.13114.

Implications for practice and research

  • The introduction of artificial intelligence (AI)-based decision support systems (DSS) in mental healthcare is at a very early stage.

  • For DSS to be relevant and cost-effective, clinicians must participate at all stages of development, from project specification to evaluation.

  • Context

    This integrative review1 investigates the evidence for incorporating AI-based DSS in mental healthcare as a partial solution to an escalating care demand which can lead to staff’s burnout and potentially unfinished or missed care. Rightly, the authors of this review mention wider systemic problems such as under-resourcing and staff shortages. A DSS is an information...

    The impact of electronic and self‐rostering systems on healthcare organisations and healthcare workers: A mixed‐method systematic review

    Abstract

    Aim

    To synthesise evidence from studies that explored the impact of electronic and self-rostering systems to schedule staff on healthcare organisations and healthcare workers.

    Design

    Mixed-method systematic review.

    Methods

    Studies were screened by two independent reviewers and data were extracted using standardised data extraction tables. The quality of studies was assessed, and parallel-results convergent synthesis was conducted.

    Data Sources

    Academic Search Complete, CINAHL, ERIC, MEDLINE, PsycINFO and PsycARTICLES were searched on January 3, 2023.

    Results

    Eighteen studies were included (10 quantitative descriptive studies, seven non-randomised studies and one qualitative study). Studies examined two rostering interventions including self-rostering (n = 12) and electronic rostering (n = 6). It was found that the implementation of electronic and self-rostering systems for staff scheduling impacted positively on both, healthcare workers and healthcare organisations. Benefits included enhanced roster efficiency, staff satisfaction, greater control and empowerment, improved work-life balance, higher staff retention and reduced turnover, decreased absence rates and enhanced healthcare efficiency. However, self-rostering was found to be less equitable than fixed rostering, was associated with increased overtime, and correlated with a higher frequency of staff requests for shift changes.

    Conclusion

    The impact of electronic and self-rostering systems to schedule staff on healthcare organisations and healthcare workers’ outcomes was predominantly positive. Further randomised controlled trials and longitudinal studies are warranted to evaluate the long-term impact of various rostering systems, including electronic and self-rostering systems.

    Implications for Healthcare

    Rostering is a multifaceted responsibility for healthcare administrators, impacting patient care quality, workforce planning and healthcare expenditure.

    Impact

    Given that healthcare staffing costs constitute a substantial portion of global healthcare expenditure, efficient and strategic resource management, inclusive of healthcare staff rostering, is imperative.

    Reporting Method

    The 27-item Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist.

    Patient or Public Contribution

    No Patient or Public Contribution.

    The Nurse‐Police Assistance Crisis Team (N‐PACT): A new role for nursing

    Abstract

    Aim

    This study aimed to gain insights into forensic nurses' perspectives and approaches to behavioural crisis situations, comparing them to disciplines traditionally involved in first-line behavioural crisis response.

    Design

    This study used a descriptive, qualitative exploratory design and was informed by Systems Theory.

    Methods

    The study was carried in the United States, between 2022 and 2023. Data were gathered through four focus groups: police officers (n = 12), co-response (mental health) clinicians (n = 13), sexual assault nurse examiners (n = 6) and correctional nurses (n = 4). Thematic analysis was performed.

    Reporting Method

    The Standards for Reporting Qualitative Research (SRQR) guidelines were used.

    Results

    Findings revealed temporal themes in crisis response: (1) Searching for Historical Information; (2) Safety and Acting at the Present Scene; and (3) Future Strategies and Interventions. Common priorities (e.g. safety and de-escalation) were identified across groups. Notably, nurses demonstrated a comprehensive approach, addressing physical and mental health assessments, substance involvement, and physical injury evaluation.

    Conclusion

    This study proposes the creation of a novel nursing role within first-line multidisciplinary teams (MDTs) for crisis response—the Nurse-Police Assistance Crisis Team (N-PACT). Nurses bring expertise and comprehensive assessment skills to enhance crisis responses, particularly in cases involving mental health emergencies, medical crises, and drug-related incidents.

    Implications

    Forensic nurses, with their diverse competencies and comprehensive training, are highly valuable assets within MDTs. Their expertise extends to proficiently conducting mental and physical assessments, ensuring safety and adeptly navigating situations that intersect with the legal system.

    Impact

    The N-PACT concept can improve outcomes and streamline the allocation of resources, particularly considering the number of police calls involving behavioural crises.

    Patient or Public Contribution

    No patient or public contribution.

    Extreme temperatures are associated with increased cardiovascular mortality

    Por: Barrett · D.

    Commentary on: Alahmad B, Khraishah H, Royé D, Vicedo-Cabrera AM, Guo Y, Papatheodorou SI, Achilleos S, Acquaotta F, Armstrong B, Bell ML, Pan SC, de Sousa Zanotti Stagliorio Coelho M, Colistro V, Dang TN, Van Dung D, De' Donato FK, Entezari A, Guo YL, Hashizume M, Honda Y, Indermitte E, Íñiguez C, Jaakkola JJK, Kim H, Lavigne E, Lee W, Li S, Madureira J, Mayvaneh F, Orru H, Overcenco A, Ragettli MS, Ryti NRI, Saldiva PHN, Scovronick N, Seposo X, Sera F, Silva SP, Stafoggia M, Tobias A, Garshick E, Bernstein AS, Zanobetti A, Schwartz J, Gasparrini A, Koutrakis P. Associations Between Extreme Temperatures and Cardiovascular Cause-Specific Mortality: Results From 27 Countries. Circulation. 2023 Jan 3;147(1):35-46. doi: 10.1161/CIRCULATIONAHA.122.061832. Epub 2022 Dec 12.

    Implications for practice and research

  • Nurses need to be aware that extreme temperatures—whether hot or cold—increase the likelihood of death from cardiovascular causes.

  • More...

  • Induction, deduction and abduction

    Por: Barrett · D. · Younas · A.

    Researchers often refer to the type of ‘reasoning’ that they have used to support their analysis and reach conclusions within their study. For example, Krick and colleagues completed a study that supported the development of an outcome framework for measuring the effectiveness of digital nursing technologies.1 They reported completing the analysis through combining ‘an inductive and deductive approach’ (p1), but what do these terms mean? How can these methods of reasoning support nursing practice, and guide the development and appraisal of research evidence?

    This article will explore inductive and deductive reasoning and their place in nursing research. We will also explore a third approach to reasoning—abductive reasoning—which is arguably less well-known than induction and deduction, but just as prevalent and important in nursing practice and nursing research.

    Inductive reasoning

    Induction, or inductive reasoning, involves the identification of cues and the collection of data to develop general...

    The role experience of advanced practice nurses in oncology: An interpretative phenomenological study

    Abstract

    Aim(s)

    To understand the experiences of advanced practice nurses working in cancer care.

    Design

    Phenomenological qualitative study.

    Methods

    Three focus groups were held to collect qualitative data. Participants were recruited through theoretical non-probabilistic sampling of maximum variation, based on 12 profiles. Data saturation was achieved with a final sample of 21 oncology advanced practice nurses who were performing advanced clinical practice roles in the four centers from December 2021 to March 2022. An interpretative phenomenological analysis was performed following Guba and Lincoln's criteria of trustworthiness. The centers' ethics committee approved the study, and all participants gave written informed consent. Data analysis was undertaken with NVivo 12 software.

    Results

    Three broad themes emerged from the data analysis: the role performed, facilitators and barriers in the development of the role and nurses' lived experience of the role.

    Conclusion

    Advanced practice nurses are aware that they do not perform their role to its full potential, and they describe different facilitators and barriers. Despite the difficulties, they present a positive attitude as well as a capacity for leadership, which has allowed them to consolidate the advanced practice nursing role in unfavourable environments.

    Implications for the Profession

    These results will enable institutions to establish strategies at different levels in the implementation and development of advanced practice nursing roles.

    Reporting Method

    Reporting complied with COREQ criteria for qualitative research.

    Patient or Public Contributions

    No patient or public contribution.

    Understanding the needs and preferences for cancer care among First Nations people: An integrative review

    Abstract

    Aim

    This systematic review aimed to identify the needs and preferences for cancer care services among Australian First Nations people.

    Design

    Integrative review.

    Data Sources

    An integrative review was conducted. A wide range of search terms were used to increase the sensitivity and specificity of the searches in electronic databases. Methodological quality assessment, data extraction, was conducted independently by two reviewers, and a narrative synthesis was conducted.

    Results

    Forty-two studies were included. A total of 2965 Australian First Nations adults, both men and women of various ages across the lifespan, were represented; no First Nations children affected by cancer were represented in the studies. Three themes emerged which included: (1) discrimination, racism and trauma, resulting from colonization, directly impacted First National people's cancer care experience; (2) cultural ways of knowing, being and doing are fundamental to how First Nations people engage with cancer care services; and (3) First Nations people need culturally safe person-centred cancer care services that address practical needs.

    Conclusion

    Most participants represented in this review experienced discrimination, racism and trauma, resulting from colonization, which directly negatively impacted Aboriginal peoples' cancer care experience. While the Optimal Cancer Pathway (OCP) was launched in Australia several years ago, people with cancer may continue to experience distressing unmet care needs.

    Patient or Public Contribution

    Our team includes both First Nations people, non-First Nations researchers and healthcare professionals with expertise in cancer care. The researchers employed decolonizing restorative approaches to ensure voice, respect, accountability and reciprocity in this review work.

    Implications for Nursing Practice

    Members of the multidisciplinary team including nurses and policymakers should reflect on these findings, ensure that they have up-to-date cultural safety training and stand together with Indigenous and non-Indigenous cancer leaders to take proactive steps to stamp out and dismantle oppression in health, and safely implement the OCP.

    Nurse experiences of partnership nursing when caring for children with long‐term conditions and their families: A qualitative systematic review

    Abstract

    Aim

    To explore the experiences of partnership nursing among nurses when caring for children and young people with long-term conditions, and their families.

    Background

    Partnership nursing is promoted as a positive model of care among paediatric nurses, where shared roles and decision-making, parental participation, mutual trust and respect, communication and negotiation are valued to create positive care experiences and enhance patient outcomes. Little is known about how nurses use partnership with both the patient and the parents in this triad to deliver partnership nursing.

    Design

    A qualitative systematic review followed Joanna Briggs Institute meta-aggregation approach and has been reported according to PRISMA guidelines.

    Methods

    A comprehensive systematic search was conducted in seven electronic databases. Studies were assessed according to a pre-determined inclusion criteria. Qualitative findings with illustrative participant quotes were extracted from included studies and grouped into categories to inform overall synthesised findings. Methodological quality assessment was conducted.

    Findings

    A total of 5837 publications were screened, and 41 qualitative studies were included. Three overarching synthesised findings were identified: (1) Using education to promote feelings of safety and support, (2) Partnering to develop a strong therapeutic relationship and (3) Optimising communication underpinned by shared decision-making principles to deliver individualised care.

    Conclusion

    Nurses demonstrated successful partnership in their practice, but focused on developing dyadic nurse–parent and dyadic nurse–child partnerships. Future practice development that creates a three-way triadic partnership may aid therapeutic relationships and shared decision-making.

    Implications for clinical practice

    Clinicians can reflect on how dyadic partnerships (focusing on the child or the parent) may exclude opportunities for coherent care. Further exploration in practice, policy and research as to how nurses determine child competency and child and parent level of engagement in triadic partnership may improve the potential of meaningful shared decision-making.

    Effects of Prebriefing Using Online Team-Based Learning in Advanced Life Support Education for Nurses

    imageAn effective prebriefing strategy is needed that can improve the learning outcomes of nurses in advanced life support education. This study aimed to identify the effects of prebriefing with online team-based learning on hospital nurses' knowledge, performance, and self-efficacy in advanced life support education. A nonequivalent control group pretest-posttest design was adopted. Nurses in the experimental group (n = 26) participated in prebriefing using online team-based learning followed by self-directed learning, whereas nurses in the control group (n = 27) experienced only self-directed learning before advanced life support education. Wilcoxon signed-ranks tests were used to identify the posttest-pretest differences of the study variables in each group. Both groups showed improved knowledge, individual performance, and self-efficacy after the education. Nurses in the experimental group reported higher self-efficacy scores compared with those in the control group. There were no differences between the experimental and control groups in knowledge, individual performances, or team performance. Online team-based learning as a prebriefing modality resulted in greater improvements in self-efficacy in advanced life support education.

    Statutory mental health services in the UK do not meet the needs of people from ethnic minority groups

    Por: Barreto · M.

    Commentary on: Bansal N, Karlsen S, Sashidharan SP, Cohen R, Chew-Graham CA, Malpass A. Understanding ethnic inequalities in mental healthcare in the UK: A meta-ethnography. PLoS Med. 2022 Dec 13;1912:e1004139. doi: 10.1371/journal.pmed.1004139.

    Implications for practice and research

  • Mental health service providers need to listen to the voices of ethnic minorities to offer services that align with their needs and experiences and reduce mental health disparities.

  • Research should evaluate the effectiveness of alternative approaches to, and co-production of, biomedical mental healthcare for specific ethnic minority groups.

  • Context

    Mental health disparities are well documented in the UK, despite free access to healthcare. Individuals from minoritised ethnic groups are more likely than white British individuals to: suffer from undiagnosed and untreated mental illness; access healthcare via crisis pathways (and less likely to access via primary care); and receive a diagnosis of severe mental illness. This is costly...

    Spanish version of the Self‐Care of Chronic Illness Inventory: A validation study amongst community‐dwelling older adults with chronic multimorbidity

    Abstract

    Aim

    To psychometrically assess the Spanish version of the Self-Care of Chronic Illness Inventory (SC-CII-Sp) in community-dwelling older adults with chronic multimorbidity.

    Design

    A methodological study.

    Method

    A total of 1260 older adults participated in the study between May 2020 and February 2022. The data were analysed using SPSS Statistics® 26 and AMOS® 24. The items' content validity index and the Fleiss' kappa were calculated to assess the SC-CII-Sp's content validity. Convergent validity was assessed by calculating the Pearson correlation coefficient between the participants' scores on the SC-CII-Sp and their scores on the Spanish Chronic Disease Self-Efficacy scale (SCD-SE). Construct validity was tested by performing a confirmatory factor analysis (CFA). The SC-CII-Sp's reliability was tested by computing the Cronbach's alpha.

    Results

    The SC-CII-Sp showed good content and convergent validity. The CFA showed that the SC-CII-Sp has three sub-scales. The 8-item Self-Care Maintenance sub-scale has good internal consistency and is comprised of two dimensions: illness-related and health-promoting behaviour. The Self-Care Monitoring sub-scale had excellent internal consistency and its five loaded items belonged to a single dimension. The 6-item Self-Care Management sub-scale has adequate internal consistency and two dimensions: autonomous and consulting behaviour.

    Conclusion

    The Spanish version of SC-CII is a valid and reliable instrument to be used in the assessment of self-care behaviours amongst Spanish-speaking, community-dwelling older adults with chronic multimorbidity.

    Implications for the Profession

    Nurses need valid and reliable tools to assess self-care behaviours in Spanish-speaking community-dwelling older adults with chronic multimorbidity. This study provides a 19-item tool that allows for the comprehensive evaluation of self-care behaviours in healthy and ill states.

    Impact

    Using the SC-CII-Sp in clinical or research settings could help nurses to examine the effects of different interventions on self-care behaviours amongst Spanish-speaking, community-dwelling older adults with chronic multimorbidity.

    Patient or Public Contribution

    None to be reported.

    The role and outcomes of music listening for women in childbirth: An integrative review

    To synthesise primary research on the role and use of music listening for women in childbirth.
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